The effects of brain endurance training on mental fatigue, endurance, and cognitive function: a systematic review and meta-analysis

This study systematically evaluated the effects of Brain Endurance Training (BET) on alleviating mental fatigue, enhancing endurance performance, and improving cognitive function through a systematic review and meta-analysis of nine peer-reviewed articles comprising 11 studies identified via a comprehensive database search following PRISMA 2020 guidelines. The pooled results demonstrated that BET significantly improved endurance performance compared to control conditions, with a more pronounced effect under fatigued conditions (SMD = 0.87, 95% CI 0.61-1.13) than at baseline (SMD = 0.21, 95% CI 0.08-0.34). Cognitive performance measures also showed substantial improvements, including faster Stroop test reaction times (Stroop-RT) (MD = 56.62, 95% CI 16.50-96.73) and enhanced Psychomotor Vigilance Task reaction time (PVT-RT) both at baseline (MD = 1.96, 95% CI 0.15-3.77) and under fatigue (MD = 18.72, 95% CI 15.27-22.18). BET exhibited significantly greater mental fatigue resistance in fatigued states (MD = 9.22, 95% CI 1.64-16.79) compared to baseline (MD = -0.54, 95% CI -2.44-1.36). Subgroup analyses revealed that no statistically significant differences were observed between subgroups based on participant characteristics or training protocols (all p > 0.05). While some descriptive numerical trends were observed, suggesting that BET might be influenced by individual differences and training design, these findings should be interpreted with caution due to overlapping confidence intervals and limited statistical power. Specifically, point estimates appeared higher in untrained individuals (SMD = 0.32, 95% CI 0.12-0.52) than in trained individuals (SMD = 0.13, 95% CI -0.04-0.30). Similarly, BET yielded comparable improvements in dynamic endurance tests (SMD = 0.22, 95% CI 0.08-0.36) and static tests (SMD = 0.19, 95% CI -0.14-0.52). Numerically larger effects were also noted when cognitive training preceded physical training (SMD = 0.33, 95% CI 0.06-0.61). In addition, interventions lasting ≥ 8 weeks (SMD = 0.27) and lower-frequency training (< 4 sessions/week) showed descriptive tendencies toward greater improvements. Overall, these findings provide preliminary quantitative insights into the impact of BET and offer preliminary references for designing specialized training protocols. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251128193.